Approximately 3 to 5 percent of children may experience a seizure, often before their first birthday, according to Children's Hospital Boston. The tonic-clonic seizure, sometimes called a grand mal seizure, is a generalized type that affects both sides of the brain. While understandably frightening for parents and baby, the tonic-clonic seizure is rarely life-threatening. The Epilepsy Foundation also notes that having one tonic-clonic seizure does not necessarily mean your your baby has epilepsy.
Description
Tonic refers to stiffening of muscles. Clonic refers to rapidly alternating contraction and relaxation of a muscle, which appears as repeated jerking. Children's Hospital Boston describes five distinct phases of a tonic-clonic seizure--the body, arms and legs of an infant contract and straighten, shake, contract and relax. The infant may make strange noises as his chest muscles tighten and push air from the lungs. Seizures typically last for two to three minutes. After the seizure, during what doctors identify as the postictal period, your infant may fall asleep or appear very sleepy. Older children sometimes express difficulty seeing or have problems with speech during the postictal period.
Causes
Nerve cells within the brain communicate with one another through electrical impulses. This activity controls all voluntary movement, such as reaching for a rattle, and involuntary movement, such as heartbeat and breathing. During a seizure, parts of the brain receive bursts of abnormal electrical signals, which interfere with normal communication between the nerve cells. This can result in the abnormal movement seen in tonic-clonic seizures. Some underlying causes of abnormal electrical signals in an infant's brain include trauma during birth, genetic abnormalities, fever or infection, a brain tumor or reaction to a medication, according to Children's Hospital Boston.
Diagnosis
Generally, an infant would be considered epileptic only after having two or more seizures. Doctors use a variety of methods to establish the cause and nature of an infant's seizures, including a full medical evaluation with physical examination and any pertinent blood work. Other diagnostic studies include electroencephalogram, or EEG, to study brain waves. Your child's doctor might also order an MRI or CT scan of the brain to look for structural abnormalities. Sometimes doctors perform a lumbar puncture to measure the pressure of the cerebrospinal fluid, or CSF, in the spinal canal and brain. They might also send a small amount of the CSF for analysis to check for infection.
Treatment
Depending upon the cause of your baby's seizures, and his overall health and age, his physician may choose to treat him with anti-seizure medications. Finding the right medication and dosage to reduce seizure frequency or eliminate tonic-clonic seizures entirely often takes time. Sometimes doctors try a special diet, the ketogenic diet. Patients are put on a high-fat, low-carbohydrate nutrition plan that causes the body to produce ketones. Doctors typically use the diet for children unable to tolerate anti-seizure medication or whose seizures are not responding to standard treatment. Children's Hospital Boston notes that no one is really sure how this diet works, but it helps some children and others show no response.
Warning
If your baby has a prolonged seizure, one lasting more than five minutes, or has several seizures in a row, the Epilepsy Foundation recommends you call for emergency medical assistance. Known as status epilepticus, prolonged seizure activity is potentially life threatening.
